Can Liver Cancer Be Found Early?

It is often hard to find liver cancer early because signs and symptoms often do not appear until it is in its later stages. Small liver tumors are hard to detect on a physical exam because most of the liver is covered by the right rib cage. By the time a tumor can be felt, it might already be quite large.

There are no widely recommended screening tests for liver cancer in people who are not at increased risk. (Screening is testing for cancer in people without any symptoms.) But testing might be recommended for some people at higher risk.

Many patients who develop liver cancer have long-standing cirrhosis (scar tissue formation from liver cell damage). Doctors may do tests to look for liver cancer if a patient with cirrhosis gets worse for no apparent reason.

For people at higher risk of liver cancer due to cirrhosis (from any cause) or chronic hepatitis B infection (even without cirrhosis), some experts recommend screening for liver cancer with alpha-fetoprotein (AFP) blood tests and ultrasound exams every 6 to 12 months. In some studies, screening was linked to improved survival from liver cancer.

Ultrasound uses sound waves to take pictures of internal organs.

AFP is a protein that can be present at increased levels in patients with liver cancer. But looking at AFP levels isn’t a perfect test for liver cancer. Many patients with early liver cancer have normal AFP levels. Also, AFP levels can be increased from other kinds of cancer as well as some non-cancerous liver conditions.

The American Cancer Society does not have recommendations for liver cancer screening.